Opinion

Challenges Of Paediatric Surgery In Nigeria

Published

2 years ago

December 8, 2023

According to the United Nations Children’s Fund (UNICEF), Nigeria is a ‘country of the young’ with 92 million of its over 200 million population under the age of 15 years. Also, according to Professor of Paediatric Surgery at the University of Lagos, and former Chief Medical Director (CMD) of University of Lagos Teaching Hospital (LUTH), Prof Christopher Bode, the number of children under 5 years old in Nigeria are over 30 million, with about 7 million new babies being born yearly. Prof Bode was the keynote speaker at the second edition of memorial lecture, held last week at the University of Port Harcourt, in honour of one of the pioneers of paediatric surgery practice in Nigeria, late Dr. Melford Graham-Douglas.
According to him, paediatric medicine is the medical care of children, a broad name for treatments for those from zero to 15 years of age, of whom Prof Bode observed are tender and voiceless, because they mostly can’t speak for themselves, depending on their parents for important lifecare decisions. Paediatric surgery which deals with surgical cares, mostly of birth defects in babies, demands the utmost skilled personnel, equipment and specialist handling, considering the tenderness of babies. Since the introduction of paediatric surgery in Nigeria, child-care professionals have continued to champion the awareness that children need specialised healthcare and infrastructure more customised to their needs as distinct from general medical practice.
Despite the achievements made so far in Nigeria in reducing infant mortality rates from previously untreatable birth defects, thanks to the foresightedness of pioneer paediatric surgeons like the late Dr Melford Graham-Douglas, enormous challenges still face the discipline from achieving its full objectives.As part of the general challenges of the Nigeria healthcare system, health screenings for disorders are mostly relegated out of ignorance, to the effect that paediatric cases requiring earlier surgeries are presented late, while most children are unable to communicate their health challenges. Where emergencies occur, paediatric surgeons have had to wait endlessly, for the general surgeons to free-up adult theatres before they could exercise efforts to rescew babies in critical conditions.
Considering that children are different in size and physiology, their cases become more delicate. Their body surface to mass ratios are much higher than in adults, that they dissipate body heat faster in normal ambient temperatures, and easily catch cold in the cold conditions of adult surgical theatres. Warmer surgical theatres designed and dedicated for children are always needed or they easily succumb to life-treathening hypothermia. Basic amenities are also needed to transport children in warm ambulances, especially babies, from hospitals of first call, to the centre of definite care.Paediatric surgeons also need to monitor children’s blood levels with specialist care because children have very low blood volumes that a minor loss could tip the balance between life and death. Due to anatomic differences from adults, children need special anaesthesia to undergo successful surgeries, and careful drug calculations to cope with their tender metabolic systems, their airways being so narrow, many routine anaestetic steps in adults are unsuitable for newborns and infants.
Drugs and the amount of fluid infusion to be administered to a child must be carefully calculated to conform with body weight, and in isothermic conditions. These are reasons paediatric surgery is such a speciality area that requires the skills set and infrastructure it deserves. It has been a huge challenge to practitioners who have had to work in poorly equipped environments. Paediatric surgery units in Nigeria should therefore be provided with neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs) to ensure adequate post-surgery cares for babies and children, in addition to providing exracorporeal membrane oxygenation (ECMO) machines.Prof Bode however regrets that low man power remains a challenge in the field. According to him, in a survey conducted in Nigeria, about 2.9 million Nigerian children live with surgically correctable conditions, meanwhile there are just 38 treatment centres and only 115 paediatric surgeons in the country, some of whom have left for greener pastures, leaving a workload of about 25,000 patients per surgeon. There are only 22 professors of paediatric surgery to train needed personnel. There is therefore a need to create significant incentives that reverse the exodus of skills.
The labours of specialist surgeons like the late Dr Melford Graham-Douglas, who worked tirelessly to save lives remain commendable and they need being immortalised as an encouragement to others. There is need to celebrate those who served humanity selflessly and bequeathed a legacy of patriotism and hardwork.Late Dr Melford Graham-Douglas was the first African surgeon under the British Technical Assistance Scheme. He was a fellow of the British Association of Paediatric Surgeons, a fellow of the Royal College of Surgeons of Edinburg and England and a fellow of the American College of Surgeons. He was the first registrar of the Nigerian Medical Council, was among the founding fathers of the University of Lagos, as well as being a council member of the universities of Ibadan and Port Harcourt, respectively. Back home, he served the Rivers State Ministry of Health as permanent secretary who laid the foundation of health infrastructure in the state. He was honoured with the Order of the Federal Republic (OFR).
An icon of the Orubibi Group of Houses in Abonnema, the University of Port Harcourt honours late Dr Melford Graham-Douglas with a Professorial Chair in Paediatric Surgery at the university’s College of Health Sciences, in recognition of his contributions to humanity. The chair, currently occupied by Prof Amabra Dodiyi-Manuel, is dedicated to research and development in paediatric surgery.Government should build upon the foundations established by men like late Dt Graham-Douglas to equip the College of Health Sciences of the great University of Port Harcourt, with state of the art facilities in paediatric surgery, as a centre of reference within the South-South region. As it stands today, there is no significant paediatric surgery centre in the region. The management of UNIPORT should engage both federal, state and regional stakeholders to ensure this becomes a reality.

By: Joseph Nwankwo

Opinion

Man and Lessons from the Lion

Published

5 days ago

September 22, 2025

The Tide

Quote:“Be not deceived; God is not mocked; whatsoever a man soweth so shall he reap also (Gal 6:7)”

The lion (Panthera leo) is a large carnivorous mammal belonging to the Felidae family. Though native primarily to sub-Saharan Africa, a small population also exists in the Gir Forest of India. Known as the “king of the jungle,” lions are iconic symbols of strength, courage, and majesty. Male lions are distinguished by their prominent manes, which vary in color and size. Their tawny coats help them blend into dry grasslands and savannas. Lions are apex predators, hunting mainly large herbivores such as zebras, antelopes, and buffaloes. They have been reverred in mythology, religion, and heraldry across cultures for millennia and they continue to feature prominently in literature, film, and national symbols around the world. Irrespective of how long the strongest lion lives and reigns in the animal kingdom, it inevitably eventually loses strength, becomes vulnerable and dies, miserably. That is the unavoidable harsh reality of this animal kingdom we call our world. As it is with the lion so it is with man and all mammals.

At the peak of the reign of the lion, it chases, catches, devours and gulps down the remains of other animals; it leaves the crumbs for hyenas in an act of generosity. However, in time, the inevitable natural occurrence takes place. The lion succumbs to the brutal reality of the aging process. It comes face to face with the realities of life after power: It can’t hunt, can’t kill or even defend itself. It roams on limbs enfeebled by time; the roars, which naturally came effortlessly thundering through the forest proclaiming its supreme reign, now require enormous effort to achieve; even a decibel audible enough to proclaim its kingship within the immediate surroundings has become a Herculean task. At this stage, the king of the jungle routinely climbs and takes refuge on trees during the day, away from hyenas that have become the predators. It is the existential reality of this stage in its life that informed the Igbo aphorism that translates thus: “Ukwu ji agu, mgbada abiaya ugwo” meaning when the lion is enfeebled, antelopes come to demand debts.

Everything it does now is with a lot of effort until it runs out of luck. The lion is cornered by a clan of hyenas that turns into a cackle with the mocking laughing-like vocalizations that characterize hyenas. The king is nibbled at and eaten alive by those it used to leave crumbs for. The hyenas won’t even let it die before they methodically dismember it thereby subjecting the “king” to the same treatment it subjected its preys during its reign. That is retributive justice. For both lion and man, life is short and physical beauty and strength are short-lived; they are ephemeral. Restated, as it is with the lion so it is with man especially those who rise to positions of great authority and enormous power in the affairs of man; more so with those who use it with reckless abandon without caring whose ox is gored. Everyone who lives long enough will naturally become weak, very vulnerable and, at some point, helpless. Therefore, let us be humble, simple and treat our fellow human beings with respect and compassion knowing that retributive justice is an immutable natural law.

Helena Blavatsky (1831–1891), the Russian philosopher and writer, who co-founded the Theosophical Society in 1875, and a key figure in introducing Eastern spirituality to the Western world, holds that every thought and act throughout life affect other members of the human family. A crime once committed and an evil thought sent out from the mind, are past recall; no amount of repentance can wipe out their results in the future. While repentance, if sincere, will deter a man from repeating errors, it cannot save him or others from the effects of those thoughts and actions; they will undoubtedly overtake him either in this life or in the next rebirth. Here lies the falsehood of vicarious remission of sins as touted in Abrahamic religions. The above highly spiritual deposition echoes the essence of the immutable law of nature, which applies to all, irrespective of station, location, color or creed. St. Paul admonished thus: “Be not deceived; God is not mocked; whatsoever a man soweth so shall he reap also (Gal 6:7).

Jesus informs thus: “I come quickly with my rewards in my hands. To give unto each man according as his works shall be (Rev. 22:12). The universality of these Biblical injunctions is found in their focus on “a man” and “each man”, respectively. Again, hinging on “soweth” and “works”, both admonitions emphasize DEEDS as the basis for salvation. History is replete with accounts of conquerors who captured vast lands, subdued millions of people and acquired stupendous wealth but who, eventually, went the way of the “King of the Jungle”. Is anyone listening? Is the roaring lion, whose thunderous voice currently permeates and sends the shivers across the length and breath of this tiny little minuscule corner of our planet, listening? Egbema people say that if a man fights different people during nine consecutive market days and his opponents are guilty every time, his kinsmen call him aside and advise him not to fight again irrespective of how right he is always.

A major difference between man and the lion is that man knows when to sheathe his sword and let peace reign. Peace is priceless and development thrives only in peaceful environments.

By: Jason Osai

Opinion

Marked-Up Textbooks:A Growing Emergency

Published

5 days ago

September 22, 2025

The Tide

Quote:”Every term that passes sees more textbooks ruined, more students misled, and more families drained financially. The impact is cumulative, and irreversible in many cases”.

In homes across Nigeria, a silent but damaging practice is taking root, one that threatens the academic future of millions of children in primary and secondary schools. The act seems harmless on the surface. Older siblings completing their homework directly inside their school textbooks. But this seemingly minor convenience is creating a dangerous ripple effect. It’s a quiet academic crisis that has now become a source of distress to countless parents, a stumbling block for students, and a ticking time bomb for the education system. What used to be a normal practice—siblings reusing textbooks year after year to ease the financial burden on families—has now turned into a nightmare. The textbooks passed down from one child to another are no longer clean, usable, or even educational. Instead, they are filled with written answers, classwork, and hastily jotted notes, making it nearly impossible for younger children to engage meaningfully with the content.

For many families, especially those living on minimum wage or below, buying new textbooks every school year is simply not an option. In Nigeria’s public schools, where education is meant to be “free,” the cost of textbooks still falls heavily on the shoulders of parents. Textbook reuse within families has long been a cost-saving strategy, but that strategy is failing fast. Marked-up textbooks don’t just present a cosmetic problem—they sabotage the very essence of learning. Younger siblings are now handed materials that have already been “solved.” They are discouraged from thinking critically, because the answers are already there, inked across the margins. In some cases, these children simply copy the answers, assuming they’re correct. In other cases, they skip lessons because the mess inside the book makes learning impossible.

Teachers, already stretched thin by overpopulated classrooms and insufficient materials, now have to deal with students who cannot follow along because their textbooks are rendered useless. The result? Classroom gaps widen, performance suffers, and students lose confidence. The situation is even more dire in rural and low-income urban areas where textbooks are shared not only among siblings but also between neighbors and classmates. A single defaced textbook can mislead multiple students. The damage multiplies. Consider the experience of the Musa family in Kaduna. With four children in public school, they rely heavily on hand-me-down books. Their youngest son, Hassan, recently failed a mathematics test not because he didn’t study, but because the textbook he used was filled with incorrect, scribbled answers from an older brother. “We didn’t realize until the damage was done,” said Mrs. Musa. “Now we have to spend money we don’t have to get new textbooks.”

It’s not just an inconvenience it’s criminal negligence. When students are forced to rely on damaged or misleading learning materials, their right to quality education is fundamentally violated. Parents who struggle to provide for their children now face another burden: replacing textbooks that should have lasted for years. This practice must stop immediately. The Federal Ministry of Education cannot continue to overlook this creeping crisis. Urgent directives must be issued to all primary and secondary schools across the country: homework and assignments must never be executed inside textbooks. This should become a standing rule, enforced at every level. There should be nationwide awareness campaigns involving Parent Teacher Associations (PTAs), school boards, local government education offices, and the media. Families must be educated on the long-term damage of using textbooks for assignments.

Students should be taught, from the earliest stages, that textbooks are reference materials not notebooks. To aid enforcement, schools should conduct textbook audits at the beginning and end of every term. Teachers should examine textbooks for signs of misuse and educate both students and parents on proper usage. Penalties for repeated violations must be considered not to punish, but to drive home the seriousness of the issue. Furthermore, the Ministry must consider subsidizing the production and distribution of standardized exercise books, which can be used for classwork and homework. If students have ample writing materials, the temptation to write in textbooks diminishes. Publishers also have a role to play. Textbooks could come with detachable worksheets or companion workbooks, separating practice materials from the core text.

Digital textbook solutions—where affordable should be encouraged in urban areas, to allow more families access to reusable content. But technology is not a silver bullet. In rural communities, the solution must still center on preserving the lifespan of print textbooks. Ministries of education at the state level must integrate textbook maintenance into their basic education policies, alongside infrastructure, teacher training, and curriculum development. This issue speaks to something bigger than books. It exposes how fragile the support systems around education have become. If Nigeria is to meet its targets for literacy, school enrollment, and youth development, it must address not only the big problems but also these smaller, dangerous oversights that quietly poison the learning process.There is no time to waste. Every term that passes sees more textbooks ruined, more students misled, and more families drained financially. The impact is cumulative, and irreversible in many cases.

Textbooks are an essential part of the learning ecosystem. When they are misused, the entire structure begins to crack. What we’re witnessing is not just careless behavior, but a systemic failure to protect educational tools. Let us be clear: a child should never be punished academically because their sibling did math homework on the same page two years earlier. That is not just unjust—it’s unacceptable. Nigeria’s promise to provide quality education for all must include a guarantee that learning materials are used properly, preserved, and accessible to every student, regardless of birth order or economic background.It is time for a national textbook integrity policy a written commitment to stop this damaging habit and restore dignity to our learning environments. Let this policy be loud, binding, and immediate.Parents must be reminded of their responsibility to provide exercise books. Schools must be empowered to enforce textbook rules. State and federal governments must invest in campaigns, materials, and monitoring systems.

If we wait longer, more children will lose their educational footing—not because they didn’t try, but because the tools they were given were already broken. The handwriting is on the wall literally. It’s time to stop writing in the books and start writing the future we want for Nigerian education.

By: King Onunwor

Opinion

Humanity and Sun Worship

Published

3 weeks ago

September 8, 2025

The Tide

Quote:”In this, the solar messiah lives on—not confined to any one culture or doctrine, but as a timeless symbol of humanity’s deepest longing for light, life, and liberation”.

From when man became conscious of his environment and began to gaze into the velvety night skies for answers to the mystery and bewilderment of his existence, his imaginative sensibilities took his thoughts in every conceivable and inconceivable direction. His observations of the visible cosmos informed speculations and conjectures that birthed beliefs. Naturally, this differed from community to community and reflected the peculiarities of peoples across the ethnocultural mosaic of humanity. Obviously, the most visible sky body that impacted and still impacts man’s everyday life is the sun. Stealthily, it sneaks up from the eastern horizon without a sound and chases away the dread of cold and darkness of the night, warms the body and provides illumination for man’s daily survivalist activities until darkness sets in and swallows it at the west end of the horizon. With time, man realised the positive effect of the sun on animals and crops, man’s source of sustainability. Thus commenced the belief in the sun as the giver and sustainer of life, hence sun worship across the world. What a benevolent mysterious entity in the clouds! What a worshipful entity! Beliefs are imbibed through acculturation and insipid indoctrination handed down from antiquity through customs, tradition, folkways and more. Generally, beliefs are accepted as given, without question; so, they are based on delusions and illusions. Confronted with facts, beliefs are either discarded or morphed into knowledge inforrmed by education, empiricism and science; most beliefs yield to new knowledge just as theories respond when confronted by facts in the Hegelian tradition. . For instance, it was believed that planet earth is flat until Galileo Galilei (1564-1642) committed what was considered “heresy” by contending that it is spherical. On the orders of the Holy See, Galileo was tied to the stake until he recanted.

Eventually, science proved otherwise, thereby jettisoning the old belief and vindicating Galileo. Today, the spherical essence of the earth is elementary Geography. Hosea says that “my people suffer because of lack of knowledge”. Also, man is admonished to “ask, and it shall be given unto you; seek, and ye shall find; knock, and it shall be opened unto you”. These two Biblical injunctions categorically nudge man towards Gnosticism, which is, succinctly stated, knowledge. It therefore behoves humanity to consistently and persistently seek knowledge towards improving the human condition, and attaining atonement (at-one-ment) with God (whoever or whatever He, She, They or It is). A study of major world religions shows that from Horus of Egyptian mythology to Jesus of Christian theology, there were numerous messianic figures whose epic share instructive commonalities with that of Jesus; incidentally, these figures preexisted Jesus with the minimum of five centuries. A chronology of these religious figures is as follows: Horus (Egypt, 3000BC), Attis (Greek, 1200BC), Mithra (Persia, 1200BC), Krishna (India, 900BC) and Dionysus, (Greek, 500BC). The commonalities in the epics are that they were (1) of mysterious birth (born of virgin), (2) born on December 25, (3) visited at birth by three star-guided wisemen/kings, (4) survived infanticide, (5) child prodigy at twelve, (6) had twelve followers, (7) known by the same gestural names such as “Lord of Lords”, “Prince of Peace”, “Savior” etc., (8) performed wondrous works, and ((9) killed, buried and resurrected on the third day. Specifically speaking, an incisive look at the above phenomenon shows that the epic of Jesus is a replica of Horus who was baptised by Anup the Baptizer (John the Baptist?) at the age of thirty years, raised El-Azur-us (Lazarus?) and had the same sobriquets: “The way, the truth, the light”, “the Messiah”, “God’s anointed son”, “Son of Man”, “the good shepherd”, “lamb of God”, “the Word”, “the morning star” and “the light of the world”.

Reacting to the uncanny commonalities in the multiplicity of theological posturing across religions, Thomas Paine (1737-1809) opined that “the Christian religion is a parody on the worship of the sun in which they put a man called Christ in the place of the sun and pay him the adoration originally payed to the sun”. Again, it is worrisome that the disciples of Jesus and virtually all biblical characters bear English names rather than Jewish or Palestinian names. Given this and the fact that they do not bear Roman names since Palestine was under Roman imperialism at the time, is telltale of strong English influence in the Christian scripture; this view is furthered by the fact that Shakespeare is carefully and craftily obfuscated in Psalm. With the above, a thawed mind would certainly agree with Paine who, in rejecting the doctrines of institutional religion, averred that “my country is the world and to do good is my religion”. Obviously, the epic of these messianic figures is a reenactment of the same old astro-theological account of the sun’s annual journey on the equinox, the Winter Solstice. Undoubtedly, from Horus to Jesus, man has been neck deep in the practice of sun worship. The multiplicity of belief systems with broad philosophical diversities and sometimes contradictory and conflicting tenets impress the individual with discerning mind that humanity is groping in the dark with each religious group claiming to be the right way. Perhaps, this informed the averment of Nobel Laureate, Wole Soyinka thus: “I am not a Christian or Muslim; neither am I an Atheist. I am a humanist; I believe in Humanism”; this is an echo of Thomas Paine. B From the falcon-eyed Horus of ancient Egypt to the crucified and risen Christ of Christianity, the motif of the solar savior has echoed across civilizations as a profound symbol of renewal, hope, and cosmic order.

Each figure—whether Mithras emerging from the rock, Dionysus reborn from death, Krishna revealing divine light, or Zoroaster proclaiming truth against darkness—embodies a facet of the sun’s eternal cycle: birth, death, and resurrection. These stories are not merely religious doctrines but reflections of a deeper mythological and psychological archetype rooted in the human experience of nature, time, and the search for meaning. The sun, in its rising and setting, becomes a metaphor for life’s cyclical nature, and the messiah—a figure who overcomes death to bring light—becomes the vessel for humanity’s spiritual aspirations. While the names, cultures, and theologies may differ, the archetypal solar messiah remains constant: a divine figure who brings order out of chaos, light out of darkness, and life out of death. Recognizing these shared motifs does not diminish the unique identities of these traditions; rather, it reveals a universal spiritual grammar through which humans, across time and space, have sought to express the inexpressible.

The eternal return of the solar savior is not just a religious myth—it is a mirror of the enduring human hope that after every night comes dawn, after every fall comes rising, and after every death, a possibility of rebirth. In this, the solar messiah lives on—not confined to any one culture or doctrine, but as a timeless symbol of humanity’s deepest longing for light, life, and liberation. The spirituality of the Torah, Bhagavad Gita, the Holy Bible, the Noble Quran and literature of other religions is absolutely in no doubt; they are indubitably, Books of Life. However, man must study them with his intellect switched on in order to discard the numerous fairytales and authorial biases. This thawed state of mind enables the true seeker to burrow beneath the narratives and unearth the deep meanings that are obfuscated in allegories, parables, metaphors and other “dark sayings”.

Humanity should realise that regardless of geology and ideology, we share the same biology; therefore, we should jettison the mind control beliefs in vicarious remission of sins, the promise of multiple voluptuous virgins etc. and work towards the brotherhood of man. Imagine a world without the divisive and destructive doctrines of institutional religion; where there is nothing to kill or die for; a world where people do to others as they wish others do unto them; where humanity returns to pre-Babelian linguistic singularity or communicates by telepathy; a world that eschews greed and men look out for each others’ need; a world in which global cohesion is such that the races (Black, Red, Yellow, and White) coalesce into one colour and humanity becomes a race of tan. Utopian? It is realizable if only man embraces the consciousness of the Divine, devoid of the man-made doctrines of institutional religion. That would be the Biblical Land of Canaan and St. Augustine’s City of God, which is governed by King Solomon’s “the righteous” and Plato’s “philosopher king”.

By: Jason Osai